306 INTERNAL SECRETION 



decisive evidence was, however, brought forward by Marie (1886) 

 who, under the name of acromegaly (abnormal growth of the 

 " acral " portions of the body), described a clinical condition, not 

 sharply separated from gigantism, which had previously attracted 

 the attention of a certain number of authors (Friedreich, hyper- 

 ostosis of the entire skeleton ; Lombroso, general hypertrophy or 

 macrosomia ; Fritsche and Klebs, gigantism). In combination 

 with Marinesco (1891), Marie showed that changes of the hypo- 

 physis, generally tumours, are invariable in this condition, and 

 it seemed from this that the cause of the peculiar anomalies of 

 growth must lie with the pathological condition of the hypophysis. 



This momentous discovery of Marie's excited an immense 

 amount of interest in the clinical and pathologico-anatomical 

 aspects of anomalous development, while at the same time it 

 pointed to the hypophysis as the centre of interest. These re- 

 searches extended to the morphology of the organ and its patho- 

 logical changes, with the result that a considerable number of facts 

 have been brought to light which largely explain its functional 

 significance. 



Physiological research was first conducted by means of 

 experimental extirpation. An important advance was made by 

 Oliver and Schafer (1894), who discovered that the watery extract 

 of hypophysis possesses distinct physiological properties. 



The most instructive 'results have been obtained, however, by 

 means of hypophysis surgery in man, and these results have been 

 confirmed and completed by recent experiments with animals. 



ANATOMY. 



The hypophysis is situated within the cranium at the base of 

 the brain ; it is connected with the latter by the infundibulum ; 

 and it more or less completely fills the sella turcica. The sella 

 turcica is lined with dura mater, which, in the form of a fibrous 

 lamella (diaphragma sellas turcica?), covers the surface of the 

 hypophysis, leaving a circular opening through which the in- 

 fundibulum passes. The lateral boundaries of the hypophysis 

 are formed by the walls of the cavernous sinus. The infundi- 

 bulum is surrounded by the circular sinus of Ridley, formed from 

 small anterior and posterior venous branches. The hypophysis is 

 separated from the internal carotid artery by the sinuses of the 

 dura mater. It lies in the anterior angle of the optic commissure, 

 the posterior portion of the organ being occasionally covered by 

 the anterior edge of the commissure. 



The hypophysis is flattened from back to front and upon the 

 surface. Its average size in an adult man is given by Erdheim 

 as follows: breadth, 14.4 mm.; thickness, 21.5 mm.; height, 

 5.5 mm. The average weight at the average age of 33 J years is 

 given by Comte as 59 eg. Caselli found that in fifty men 



